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Portosystemic shunt

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https://www.readbyqxmd.com/read/30317791/-follow-up-study-of-116-cases-of-transjugular-intrahepatic-portosystemic-shunt-in-the-treatment-of-cirrhotic-portal-hypertension
#1
M H Liu, F Zhou, X B Wang, L P Chen, G Z Li, Q Zhao
Objective: To investigate the incidence rate of transjugular intrahepatic portosystemic shunt (TIPS) complications in the treatment of cirrhotic portal hypertension, and analyze the cause of complication to management methods. Methods: Data of 116 patients obtained from Zhongnan Hospital of Wuhan University were retrospectively analyzed. Portal venous pressure, routine blood test, coagulation test, liver and kidney function test, ammonia blood test, imaging and endoscopy reports were collected before and after procedure...
August 20, 2018: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/30315180/benefits-of-early-treatment-for-patients-with-hepatic-myelopathy-secondary-to-tips-a-retrospective-study-in-northern-china
#2
Hongwei Zhao, Zhendong Yue, Lei Wang, Zhenhua Fan, Fuliang He, Xiaoqun Dong, Fuquan Liu
Transjugular intrahepatic portosystemic shunt (TIPS) is an effective therapy for reducing portal pressure. Hepatic myelopathy (HM), a rare complication of chronic liver diseases, remains obscure in terms of treatment and prognosis. We aimed to determine an optimal treat strategy for patients with HM after TIPS. Twenty-nine patients who developed HM after TIPS were stratified by time-lapse from onset to treatment: group A (n = 16), <6 months; group B (n = 13), ≥6 months. Therapeutic measures included shunt-limiting and medical treatments...
October 12, 2018: Scientific Reports
https://www.readbyqxmd.com/read/30302042/race-and-gradient-difference-are-associated-with-increased-risk-of-hepatic-encephalopathy-hospital-admission-after-transjugular-intrahepatic-portosystemic-shunt-placement
#3
Michael W Rowley, Myunghan Choi, Steve Chen, Kevin Hirsch, Anil B Seetharam
Background/Aims: Hepatic encephalopathy (HE) is a well-recognized complication of transjugular intrahepatic portosystemic shunt (TIPS) placement. The aim of this investigation was to evaluate incidence and predictors of post-TIPS HE necessitating hospital admission in a non-clinical trial setting. Methods: We performed a retrospective cohort study identifying 273 consecutive patients undergoing TIPS from 2010 to 2015 for any indication; 210 met inclusion/exclusion criteria...
September 2018: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/30292761/evidence-for-an-association-between-intrahepatic-vascular-changes-and-the-development-of-hepatopulmonary-syndrome
#4
Clément Lejealle, Valérie Paradis, Onorina Bruno, Emmanuelle de Raucourt, Claire Francoz, Olivier Soubrane, Didier Lebrec, Pierre Bedossa, Dominique Valla, Hervé Mal, Valérie Vilgrain, François Durand, Pierre-Emmanuel Rautou
BACKGROUND: s: Hepatopulmonary syndrome (HPS) is characterized by an arterial oxygenation defect - defined by an increased alveolar-arterial oxygen gradient - induced by pulmonay vascular dilatations in the context of liver disease. The pathogenesis of HPS is poorly understood. Morphological changes associated with HPS are unknown. This study aimed at describing imaging and pathology changes associated with HPS. METHODS: We performed a case-control study in candidates for transplant with suspicion of cirrhosis...
October 4, 2018: Chest
https://www.readbyqxmd.com/read/30291382/technical-success-and-outcomes-in-pediatric-patients-undergoing-transjugular-intrahepatic-portosystemic-shunt-placement-a-20-year-experience
#5
Jacob S Ghannam, Michael R Cline, Anthony N Hage, Jeffrey Forris Beecham Chick, Rajiv N Srinivasa, Narasimham L Dasika, Ravi N Srinivasa, Joseph J Gemmete
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) placement has been extensively studied in adults. The experience with TIPS placement in pediatric patients, however, is limited. OBJECTIVE: The purpose of this study was to report technical success and clinical outcomes in pediatric patients undergoing TIPS placement. MATERIALS AND METHODS: Twenty-one children - 12 (57%) boys and 9 (43%) girls, mean age 12.1 years (range, 2-17 years) - underwent TIPS placement from January 1997 to January 2017...
October 6, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/30288582/shear-wave-elastography-prior-to-transjugular-intrahepatic-portosystemic-shunt-may-predict-the-decrease-in-hepatic-vein-pressure-gradient
#6
Dina Attia, Thomas Rodt, Steffen Marquardt, Jan Hinrichs, Bernhard C Meyer, Michael Gebel, Frank Wacker, Michael P Manns, Andrej Potthoff
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure used to treat portal hypertension complications. Our aim was to evaluate liver and spleen stiffness measurement (LSM and SSM, respectively) changes using acoustic radiation force impulse imaging (ARFI) in comparison to Child-Pugh scores for predicting hepatic venous pressure gradient (HVPG) decreases after TIPS implantation. METHODS: This prospective study included 31 consecutive clinically significant portal hypertension patients with TIPS indication...
October 4, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/30285813/long-term-clinical-outcomes-in-patients-with-viral-hepatitis-related-liver-cirrhosis-after-transjugular-intrahepatic-portosystemic-shunt-treatment
#7
Dengke Teng, Hao Zuo, Lin Liu, Jinghui Dong, Lei Ding
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) procedure has played a vital role in management of portal hypertension. Thus, we aimed to investigate the natural history, long-term clinical outcome, predictors of survival in viral hepatitis related cirrhotic patients post-TIPS. METHOD: A total of 704 patients with complete followed-up data were enrolled, and clinical characteristics of patients were collected and analyzed. Kaplan-Meier method was used to calculate survival, and comparisons were made by log rank test...
October 1, 2018: Virology Journal
https://www.readbyqxmd.com/read/30279099/treatment-of-peristomal-hemorrhage-a-review-of-outcomes-and-comparison-of-two-minimally-invasive-techniques
#8
S Young, J Wong, M Rosenberg, J Golzarian, N Frank
PURPOSE: The purpose of this study was to review and compare outcomes between percutaneous sclerotherapy and transjugular intrahepatic portosystemic shunt (TIPS) treatments in patients with peristomal variceal bleeding. MATERIALS AND METHODS: Ten patients who underwent sclerotherapy (n = 3 patients), TIPS placement (n = 5 patients) or both (n= 2 patients) for peristomal variceal bleeding were retrospectively reviewed. There were 6 women and 4 men, with a mean age of 62...
September 29, 2018: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/30270689/clinical-characteristics-of-patients-with-liver-cirrhosis-and-spontaneous-portosystemic-shunts-detected-by-ultrasound-in-a-tertiary-care-and-transplantation-centre
#9
Michael Lipinski, Michael Saborowski, Benjamin Heidrich, Dina Attia, Philipp Kasten, Michael P Manns, Michael Gebel, Andrej Potthoff
OBJECTIVES: The clinical relevance of spontaneous portosystemic shunts detected by ultrasound is insufficiently investigated. The aim of this retrospective study was to assess the frequency and clinical relevance of spontaneous portosystemic shunts in patients with liver cirrhosis. METHODS: We evaluated portosystemic shunts, liver cirrhosis and spleen size by ultrasound in 982 patients with liver cirrhosis and correlated these with laboratory results, clinical data and the incidence of clinical endpoint deaths, liver transplantation and the development of HCC during the follow-up period (mean 1...
September 29, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/30263145/erratum-recanalisation-of-a-congenital-extrahepatic-portosystemic-shunt-previously-attenuated-with-cellophane-banding-in-a-cat
#10
(no author information available yet)
[This corrects the article DOI: 10.1177/2055116918795717.].
July 2018: JFMS Open Reports
https://www.readbyqxmd.com/read/30262421/transjugular-intrahepatic-portosystemic-shunt-for-the-prevention-of-recurrent-esophageal-variceal-bleeding-in-patients-with-cavernous-transformation-of-portal-vein
#11
Zhao-Peng Li, Sui-Sui Wang, Guang-Chuan Wang, Guang-Jun Huang, Jing-Qin Cao, Chun-Qing Zhang
BACKGROUND: Treatment options for patients with cavernous transformation of portal vein (CTPV) are limited. This study aimed to evaluate the feasibility, efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) to prevent recurrent esophageal variceal bleeding in patients with CTPV. METHODS: We retrospectively analyzed 67 consecutive patients undergone TIPS from January 2011 to December 2016. All patients were diagnosed with CTPV. The indication for TIPS was a previous episode of variceal bleeding...
September 7, 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/30254403/pediatric-hepatocellular-carcinoma
#12
REVIEW
Rajeev Khanna, Sanjeev Kumar Verma
Pediatric hepatocellular carcinoma (HCC) is the second common malignant liver tumor in children after hepatoblastoma. It differs from the adult HCC in the etiological predisposition, biological behavior and lower frequency of cirrhosis. Perinatally acquired hepatitis-B virus, hepatorenal tyrosinemia, progressive familial intrahepatic cholestasis, glycogen storage disease, Alagille's syndrome and congenital portosystemic shunts are important predisposing factors. Majority of children (87%) are older than 5 years of age...
September 21, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/30251431/health-related-quality-of-life-following-surgical-attenuation-of-congenital-portosystemic-shunts-versus-healthy-controls
#13
P Bristow, V Lipscomb, A Kummeling, R Packer, H Gerrits, K Homan, V Ortiz, K Newson, M Tivers
OBJECTIVES: To design a health-related quality of life questionnaire for dogs with congenital portosystemic shunts, use it in a cohort of dogs treated with suture attenuation and compare results with those obtained from a healthy control cohort. MATERIALS AND METHODS: Data were collected from the hospital records of dogs treated with suture ligation of an intrahepatic or extrahepatic congenital portosystemic shunt at two referral centres. Owners were asked to complete a questionnaire assessing their dog's health-related quality of life preoperatively (retrospectively) and at the time of follow-up...
September 25, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/30248224/outcomes-after-placement-of-a-sx-ella-esophageal-stent-for-refractory-variceal-bleeding-a-national-multicenter-study
#14
Nikolaus Pfisterer, Florian Riedl, Thomas Pachofszky, Michael Gschwantler, Kurt König, Benjamin Schuster, Mattias Mandorfer, Irina Gessl, Constanze Illiasch, Eva-Maria Fuchs, Lukas Unger, Werner Dolak, Andreas Maieron, Ludwig Kramer, Christian Madl, Michael Trauner, Thomas Reiberger
BACKGROUND: Current guidelines favour the use of bleeding stents over balloon tamponade (BT) for refractory variceal bleeding (VB) from oesophageal varices. However, data on the efficacy and safety of self-expandable metal SX-ELLA Danis stents (SEMS) are limited. METHODS: Cirrhotic patients receiving SEMS for VB at four tertiary care centres were included in this retrospective multicentre study. Rates of failure-to-control bleeding (within 5 days) and bleeding-related mortality (6 weeks) were assessed...
September 24, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/30223282/doppler-ultrasound-surveillance-of-tips-patency-in-the-era-of-covered-stents-retrospective-analysis-of-a-large-single-center-cohort
#15
Christoph Klinger, Bettina Riecken, Johannes Müller, Anja Westphal, Joachim Löffler, Eckhart Froehlich, Karel Caca
PURPOSE:  The purpose of this study was to determine accuracy and necessity of long-term Doppler ultrasound (DU) surveillance of transjugular intrahepatic portosystemic shunt (TIPS) patency after implantation of an ePTFE-covered stent-graft (Viatorr). METHODS:  This single-center retrospective study includes 228 consecutive cirrhotic patients with TIPS implantation due to portal hypertensive complications. Standardized DU surveillance was scheduled 3 - 5 days, 3 months, and 6 months after TIPS implantation and every 6 months thereafter...
September 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/30223273/hepatorenal-syndrome-or-hepatocardiorenal-syndrome-revisiting-basic-concepts-in-view-of-emerging-data
#16
REVIEW
Amir Kazory, Claudio Ronco
BACKGROUND: Accumulating evidence on the pathophysiology of hepatorenal syndrome has challenged the conventional model of liver-kidney connection. While liver cirrhosis is traditionally considered the origin of a cascade of pathophysiologic mechanisms directly affecting other organs such as the kidney, emerging data point to the heart as the potential mediator of the untoward renal effects. SUMMARY: Herein, we briefly review the often-overlooked contribution of the heart to circulatory dysfunction in hepatorenal syndrome and put forward evidence arguing for the involvement of systemic inflammation and endothelial dysfunction in this setting...
September 17, 2018: Cardiorenal Medicine
https://www.readbyqxmd.com/read/30212817/treatment-of-oesophageal-varices-in-liver-cirrhosis
#17
Tilman Sauerbruch, Florence Wong
BACKGROUND: The development of cirrhosis with resultant portal hypertension can lead to oesophageal varices at a rate of 7% per annum. Bleeding from varices happens when the portal pressure is ≥12 mm Hg and can threaten life. SUMMARY: Eliminating the aetiology of cirrhosis is a pivotal step to prevent the formation of varices. In patients with established varices, primary prophylaxis with non-selective beta blockers (NSBB) may slow down the progression of varices and prevent the first variceal bleed...
September 13, 2018: Digestion
https://www.readbyqxmd.com/read/30210895/direct-intrahepatic-portosystemic-shunt-in-budd-chiari-syndrome-a-case-report-and-review-of-the-literature
#18
V Chandra, E Wajswol, M Shahid, A Kumar, S Contractor
Transjugular intrahepatic portosystemic shunt (TIPS) is an alternative interventional procedure used to manage refractory Budd-Chiari syndrome (BCS) when conservative medical therapy has failed. However, TIPS is not always technically successful because of hepatic vein thrombosis and inability to catheterize the hepatic veins. In these situations, direct intrahepatic portosystemic shunt (DIPS) with access to the portal vein from the IVC has been shown to be a viable alternative that may ameliorate portal hypertension in these patients...
2018: Case Reports in Radiology
https://www.readbyqxmd.com/read/30210858/pulmonary-glue-embolism-an-unusual-complication-following-endoscopic-sclerotherapy-for-gastric-varices
#19
Philips G Michael, Georgios Antoniades, Anca Staicu, Shahid Seedat
A pulmonary glue embolism is an unusual but potentially life-threatening complication following the treatment of variceal bleeding, especially in patients with large varices requiring large volumes of sclerosant. Other contributory factors include the rate of injection and ratio of the constituent components of the sclerosant (i.e. n-butyl-cyanoacrylate and lipiodol). This condition may be associated with a delayed onset of respiratory compromise. Therefore, a high degree of clinical suspicion is essential in patients with unexplained cardiorespiratory decline during or following endoscopic sclerotherapy...
May 2018: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/30197446/spongiform-encephalomyelopathy-in-a-calf-with-a-congenital-portosystemic-shunt
#20
Janna Pietersma
A 3-month-old Holstein heifer calf was presented because of an abnormal gait. Further examination revealed cranial nerve deficits, including a severely delayed corneal reflex. The calf was not ataxic and maintained an appetite, but was considerably stunted for her age. A postmortem examination resulted in a diagnosis of a congenital portosystemic shunt.
September 2018: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
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